Visit the Long Term Plan's website at: https://www.longtermplan.nhs.uk/
The NHS LTP has been established to protect the NHS now and in the future. It is designed to incorporate general health and wellbeing as well as treatment and care, ensuring that prevention of health problems is very much at the heart of NHS operations. The £20.5 billion budget increase is the biggest cash increase in the history of the NHS, and will go towards growing the workforce, preventing illness, improving technology and reducing health inequalities. As well as the increase in budget, this can be achieved through streamlining processes to ensure that there is no waste. For example, use of technology to store and share data is both more secure and more efficient, and therefore a saving.
In 2018/2019 the NHS is expected to spend £126 billion. The budget increase announced in June 2018 and detailed in the NHS LTP will take the annual budget to approximately £157 billion by 2023. (Link)
While general wellbeing has been a part of healthcare for some time, the LTP is establishing a focus on prevention, not just curing illness. In addition to existing information campaigns focusing on individual wellbeing, new screening methods will include earlier testing for bowel cancer, more targeted screening, and the establishment of Rapid Access Diagnostic Centres to enable doctors to give a diagnosis on the same day as testing. The aim is that, in 10 years’ time, 55,000 more people will survive cancer each year, and 100,000 heart attacks, strokes and dementia cases will have been prevented.
As part of the plan to promote prevention, there will be an increased focus on primary and community services, increasing funding by £4.5 billion per year by 2023/2024.
Prevention will help to reduce demand on hospital services, which is continuing to rise. Already steps have been taken to promote the ‘Pharmacy First’ protocol which encourages people to speak with a pharmacist about minor ailments or problems which can be solved with over-the-counter medicine instead of making an appointment with a GP. The LTP takes this further, by helping people to cut risk factors, by quitting smoking, reducing alcohol consumption, and losing weight. In 2015/2016 there were 16 million total hospital admissions in England. This is 28 per cent more than a decade previously. (Link)
In order to deliver these wide-ranging changes and improved services, there will be a need to recruit more staff in all aspects of the health service. As well as an increase in staff numbers there will be opportunities for more and better training and support for career progression. The NHS should be an employer of choice, offering flexible contracts and pensions, helping to improve retention. In particular there will be a focus on staff in mental health, primary care and community services.
By retaining a stronger and larger workforce, the NHS will be better equipped to deliver a joined-up approach across all aspects of health and social care. This will be done in tandem with local authorities and existing social care and public health organisations.
In September 2018, across Hospital and Community Healthcare Services (HCHS), the NHS employed (full-time equivalent): 111,247 doctors; 285,674 nurses and health visitors; 21,323 midwives; 139,241 scientific, therapeutic and technical staff; 20,951 ambulance staff; 23,100 managers; and 10,365 senior managers. (Link)
One of the funding priorities of the NHS LTP is maternity care, through improved safety in maternity services as well as increased support for new parents for mental health. As well as being one of the best healthcare systems in the world, the NHS will be one of the safest places to bring children into the world.
Following the publication of the Children and Young People’s Mental Health Green Paper, there is a focus in the LTP on mental wellbeing. As well as support in schools with designated mental health leads, services for young people will be expanded to include anyone up to the age of 25, and there will be targets for community mental health services to ensure that people are getting the help that they need when they need it. There will be an additional £2.3 billion invested in mental health through the long term, giving 350,000 more children mental health support and giving more adults access to talking therapies.
Providing for the long-term future of the NHS will ensure that families who most need help will be able to access it. While life expectancy is generally longer for women than for men, in certain more deprived areas this discrepancy is much wider. Reducing health inequalities can be achieved by:
- Intervening at different levels of risk
- Intervening for impact over time
- Intervening across the life course
This should be delivered systematically across the population. (Link)
From January 2019, NHS Trusts are no longer able to purchase fax machines, and the NHS should be fax free by March 2020. (Link) This step towards digitising information will make calling up patient data simpler, ensuring that health practitioners have all the necessary information in front of them when they need it.